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• • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 l (E)everetteps@everettwagov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION �. <br /> PROJECT ADDRESS: 4510 Riverfront Blvd <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: Ili SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ID MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> E CTRICAI.AP iN 110 +11 ' " <br /> CONTRACT PRICE OF WORK: $ 250 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable) <br /> DESCRIPTION OF WORK: 100 amp temp <br /> lot 216 <br /> Please call our office @ 253-872-6051 (ask for Alicia please) for payment when permit is ready Thank you <br /> CONTACT INFORMATION <br /> OWNER NAME: Polygon Homes TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 11624 SE 5th St Suite 200 <br /> • Bellevue STATE WA 98005 <br /> OWNER PHONE: 425-586-7700 OWNER EMAIL: <br /> CONTRACTOR NAME: Garner Electric Washington LLC <br /> CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Suite 106 <br /> cm, Puyallup STATE WA 2,P 98371 <br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: bgentele©gweusa.com <br /> CONTRACTOR LIC.#(REQUIRED): GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED;: 052909 <br /> PRIMARY CONTACT: 0 OWNER (a CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-872-6051 <br /> Paul Vantol CONTACT EMAIL: pvantol@gweusa.com <br /> AGREEMENT 1 hereby certify that I have read and examined this application and know the same to be true and correct, All provisions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to give authonty to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 1S.21 RCW and 296,200 WAC <br /> city of Everett Official Use Only <br /> PERMIT# <br /> r O ff• 2114118 E 1Y)02 OC1(K <br /> bwnerlAutharized Agent Signature Date (Revised 9/23/2016) <br />